Effects of cold and compression dressings on early postoperative outcomes for the arthroscopic anterior cruciate ligament reconstruction patient

Efforts to minimize the morbidity of anterior cruciate ligament (ACL) reconstruction include the use of cryotherapy and/or compressive dressings in the immediate postoperative period. We undertook the present study to determine if the alleged benefits of the Cryo/Cuff, which combines these modalities, are more attributable to its compressive effect rather than cold application. Seventy-eight patients admitted for primary endoscopic ACL reconstruction using a bone-patella tendon-bone autograft were randomized to receive Cryo/Cuff compressive dressings postoperatively. Forty subjects (Group 1) had the cuff applied with continuous circulating ice water using the Autochill device, while 38 others (Group 2) received the cuff with room temperature water. Cases were performed as inpatients and all subjects were administered intravenous morphine postoperatively via a patient-controlled infusion pump for the first 24 postoperative hours. At baseline, the groups were well matched in age, sex, duration of symptoms, operative time, and associated meniscal surgery. No significant difference between groups was detected with respect to length of hospitalization, Hemovac knee drainage, oral and intravenous narcotic requirement, or subjective pain as measured by a visual analog scale. No apparent complications related to the use of the Cryo/Cuff dressings were noted. The clinical effect of the Cryo/Cuff in this study was not influenced by the use of continuous ice water vs. room temperature water. Further study should focus on variations in compression to evaluate the clinical impact of this device.